Shawn Taylor Grimsley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA20840 Issued in TX

Practice address

1101 Wolf Lake Dr # 225a
Georgetown, TX 78628-3778

Phone

(512) 691-6511

NPI assigned

Oct 9, 2026

Last updated

Oct 9, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1791504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791504000000",
    "number": "1538064662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 WOLF LAKE DR # 225A",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283778",
            "telephone_number": "512-691-6511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 WOLF LAKE DR # 225A",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283778",
            "telephone_number": "512-691-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMSLEY",
        "first_name": "SHAWN",
        "middle_name": "TAYLOR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-09",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA20840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Carly Gubin

• Physician Assistant in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.